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CICE Secondary Application Form
The Community Integration Through Cooperative Education (CICE) Program

Applicant Information

This is provided to you after you have applied through OntarioColleges.ca. You cannot complete this form without your Humber student number. If you do not have the Humber student number, please make sure you have applied through OntarioColleges.ca first and wait to receive your Humber student number.
Resume Upload (PDF, Word only)
Please click on the box below and select a file from your computer to upload.
IEP Upload (PDF, Word only)
Please click on the box below and select a file from your computer to upload.
Psycho-Educational Report, if available (PDF, Word only)
Please click on the box below and select a file from your computer to upload.

Contact Information

Please enter the applicant's email address. All updates from the CICE Program and Humber will be sent to the email address provided here.

Mailing Address:

Program Availability

Humber's CICE program is available to domestic students only. The CICE program is unavailable to international students.

Educational History

I have graduated with or am working towards:

Letter from Developmental Services Ontario (DSO) Upload (PDF, Word only)
Please click on the box below and select a file from your computer to upload.

Admission Criteria

Note: Applicant must meet both criteria in order to be considered for an interview

I have included in my application:

IEP Confirmation Upload (PDF, Word only)
Please click on the box below and select a file from your computer to upload.
Other Document Upload (PDF, Word only)
Psychoeducational Report (Do not submit for application. Bring full report if granted an interview)
Please click on the box below and select a file from your computer to upload.

NOTE: This application MUST be accompanied by a copy of documentation that confirms an intellectual/developmental disability such as an Individual Education Plan. Without the accompanying document, the application for the CICE Program cannot be processed.

Although we recognize that many students might benefit from a program like ours, we often have more qualified students than we have space available and not all students will be accepted into the program. If you are not accepted, you are welcome to reapply the following year.

When you sign this application, it means that you are giving us permission to talk about you.

I certify that the above information is true and complete. I understand that any false or incomplete information submitted in support of my application may invalidate my application.

Humber Polytechnic will collect your personal information in accordance with its role as a post-secondary institution for the provision of the Community Integration through Cooperative Education (CICE) Program.

We need to collect and use this information during the CICE registration process in order to assess your eligibility and register you for the program. Information collected by Humber Polytechnic may be used or disclosed for various educational, administrative, safety, security, research and/or statistical purposes of Humber Polytechnic and/or Ministries and agencies of the Government of Ontario and the Government of Canada in compliance with its role as a post-secondary educational institution. For clarity, the information collected from your CICE Application and interview may be shared with Humber Polytechnic Accessibility Services.

Humber Polytechnic does not sell, assign, lease or otherwise disclose or permit disclosure of your personal information except as: permitted by this statement; with your prior written consent or as required to comply with legal and regulatory requirements.

By submitting your personal information and registration form, you consent to the collection, use and disclosure of the information by Humber Polytechnic in accordance with the above.

Questions about the collection, use and disclosure of student information by Humber Polytechnic should be directed to: Chief Privacy Officer, Office of the Associate Vice-President, Legal and Risk Management, 205 Humber College Boulevard, LRC 6th Floor, Toronto, ON M9W 5L7

Once you click the Submit button, your application will be submitted and you will be sent a confirmation email.

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